Advances in inducing adaptive immunity using cell-based cancer vaccines: Clinical applications in pancreatic cancer

Table 3 Clinical trials of whole tumor cell-based cancer vaccines in pancreatic cancer patients

Cell-based cancer vaccines	Vaccine	Phase	Patients	Results	Ref.
Whole tumor cell	GM-CSF-secreting allogeneic pancreatic cancer cell lines (GVAX) and chemoradiotherapy	Phase II	14 patients with resected pancreatic cancer	3 patients were disease free at least 25 mo after diagnosis	[76]
	GVAX (arm A)/GM-CSF vaccine and cyclophosphamide (arm B)	Phase II	50 patients with pancreatic cancer (2 arm)	Median OS: 2.3 mo in arm A, 4.3 mo in arm B	[77]
	GVAX and chemoradiotherapy	Phase II	60 patients with resected pancreatic cancer	Induction of mesothelin-specific CD8+ T cells correlated with disease-free survival. Median OS: 24.8 mo	[78]
	Ipilimumab (anti-CTLA-4 monoclonal antibody) alone (arm 1), Ipilimumab and GVAX (arm 2)	Phase II	30 patients with pancreatic cancer (2 arm: 1:1)	Three of 15 patients had evidence of prolonged disease stabilization (31, 71, and 81 wk) and 7 patients experienced CA19-9 declines (arm 1). In 2 of these patients, disease stabilization occurred after an initial period of progression. The median OS was 5.7 mo and 1 yr OS was 27%. Among patients with OS > 4.3 mo, there was an increase in the peak mesothelin-specific T cells and enhancement of the T-cell repertoire.	[79]
	GVAX	Phase II	39 patients with pancreatic cancer	GVAX treatment was associated with the formation of vaccine-induced intratumoral tertiary lymphoid aggregates in 33 of 39 patients. Enhanced CD8+ CTL responses against multiple mesothelin-specific epitopes that have been correlated with survival benefits were also found.	[80]
	GVAX with low-dose cyclophosphamide (Cy) followed by CRS-207 (live-attenuated Listeria monocytogenes-expressing mesothelin) (arm A), GVAX + Cy (arm B)	Phase II	90 patients with pancreatic cancer	Enhanced mesothelin-specific CD8+ CTL responses were associated with longer OS. Median OS was 9.7 mo (arm A, n = 61).	[81]
	Algenpantucel-L (2 pancreatic cancer cell lines that have been modified to express alpha-gal)	Phase II	62 patients with resected pancreatic cancer	The 12-mo disease-free survival was 62%, and the 12-mo overall survival was 86%; the phase III study is ongoing.	[82]